| NPI | 1760669147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAURISE GENE VANDERGRIFF Owner 423-479-4397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: TN DPO636) |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2008-01-28 |